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Friday, March 24, 2017

Healthy Habits: Apps and Health

A
new, wide-ranging review of available research shows parents and
caregivers can improve health outcomes for kids by using mobile-phone
apps and text messaging.

The
research appears in the prestigious, peer-reviewed journal JAMA
Pediatrics on March 20. Previous to this investigation, the only
across-the-board review of mobile health (mHealth) effectiveness
centered on childhood obesity alone.

“The
take-home message is that a smartphone can help a child be healthier
across a number of health care behaviors, like making sure they get
vaccines or eat a healthy diet,” said Christopher Cushing, assistant
professor of clinical child psychology at the University of Kansas, who
co-authored the findings. “We have some idea that a smartphone and
messaging can be a good way to go, but we also have a long way to go to
optimize this kind of intervention.”

The researchers
analyzed 37 unique studies of mobile health interventions, looking for
statistical evidence of changes in health behavior or disease control in
participants 18 years old or younger.

Cushing’s
collaborators include lead author David Fedele as well as Alyssa Fritz
and Adrian Ortega of the University of Florida, and Christina Amaro of
KU’s Clinical Child Psychology Program.

According to
lead author Fedele, the study suggests that health care providers should
encourage mobile-phone-based tech for their patients.

“Findings
from the current study indicate that mHealth interventions are a
promising and potentially effective route for pediatric health care
providers to use with patients and their family members,” he said.

Benefits
could come with simple or more complex smartphone interventions, the
researchers found. Their study looked at the benefits of all types of
mHealth technology but didn’t find advantages of one kind over another.

“It’s
worth using, and there a lot of different media that can be used,”
Cushing said. “mHealth interventions can be as simple as text messages
and as complicated as a dedicated app. You can go small and send text
messages for vaccine reminders or build an app that allows for diet and
physical activity tracking.”

For parents, Cushing said a key finding suggests they “be involved in the technology.”

“If
they have a young child, they could opt into a scheduling program that
would allow them to see those things that are due for the child like a
vaccination,” he said. “For an older child, it’s appropriate for the
child to take on some autonomy such as engaging with an app where they
can set goals and get feedback. But the parent should be engaged in that
system so they can use teachable moments. If a child isn’t sure about
why they’re not meeting goals, a parent can use adult problem-solving to
help find an answer.”

According to
Cushing, the findings should be relevant to parents, caregivers and
pediatricians but also should motivate the technology community. For
instance, the research team found that interventions where parents were
involved in mHealth technology revealed greater health benefits to
children.

“If
you’re designing technology, design it so parents and children interact
around the technology,” he said. “You get a bigger bang for your buck.”

The ubiquity of mobile phones today contributes to the effectiveness of mHealth technology, according to the researchers.

“With
an overwhelming percentage of individuals owning or having access to a
mobile phone, mHealth interventions can have greater reach than
in-person interventions,” Fedele said. “Furthermore, mHealth programs
can collect dynamic health-related data and deliver intervention content
to individuals in their natural environment, outside of a clinical
encounter, at key times that have a higher likelihood of modifying
behavior. An example could be collecting data on percentage of time an
individual has spent in sedentary activity and then delivering an
individually tailored message to their mobile device promoting them to
engage in some sort of physical activity.”

The
researchers hoped to follow up the investigation by discovering more
about which behavior changes boost the effect of these types of
interventions.

“We
know that mHealth interventions can work and that parents should be
involved, but we are left to guess at what specific strategies they
should include,” Cushing said.

In future research, the investigators aim to look at the efficacy of specific apps on the marketplace.

“Now
that we know that these approaches can work, it would be a good idea to
learn more about what features are valued by consumers and whether
those features appear in commercially available apps,” Cushing said.